Effectiveness of a Hydrophobic Dressing for Microorganisms' Colonization and Infection Control of Vascular Ulcers

NCT ID: NCT03667937

Last Updated: 2020-03-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

204 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-05-15

Study Completion Date

2021-04-30

Brief Summary

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This study will determine the effectiveness of CUTIMED® hydrophobic dressings against AQUACEL® silver dressings in bacterial colonization of vascular ulcers.

Detailed Description

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Chronic wounds with torpid evolution are a real challenge for health services today. In the case of venous ulcers, it is estimated that more than 80% of these wounds may be colonized or infected by bacteria, which is associated with its chronification by delaying the healing process.

The most widespread therapeutic strategy in routine clinical practice is the use of silver dressings, due to its high antimicrobial power, although the effectiveness of these in venous ulcers is not supported by solid evidence. In addition, there are some uncertainties about the possible adverse effects of systemic absorption of silver molecules, as well as bacterial resistance to silver and the high cost associated with prolonged treatments.

In this sense, a novel method to deal with this problem is the use of dressings with high hydrophobic power, such as CUTIMED®.

Conditions

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Venous Leg Ulcer Bacterial Infections Chronic Ulcer of Skin of Lower Limb Nos

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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CUTIMED

After an initial culture to determine the bacterial load by smear, we will proceed to the cure of the ulcer by washing the area with physiological saline solution and to mechanical debridement, if necessary, to apply the CUTIMED dressing. It will be covered with a secondary gauze dressing and a double compression bandage with a normal crepe bandage.

If the wound exudate decreases, or the removal of the dressing is difficult, it will be changed to CUTIMED gel; in case of abundant exudate, the use of alginate without silver will be allowed for the treatment, because it is neutral with the bacterial load, placed on the CUTIMED dressing.

Primary and secondary end-points will be measured at baseline and at 4, 8 and 12 weeks, except quality of life (only baseline and at 12 weeks).

Group Type EXPERIMENTAL

CUTIMED

Intervention Type COMBINATION_PRODUCT

Hydrophobic Dressing

AQUACEL silver

After an initial culture to determine the bacterial load by smear, we will proceed to the cure of the ulcer by washing the area with physiological saline solution and to mechanical debridement, if necessary, to apply Aquacel-Ag. It will be covered with a secondary gauze dressing and a double compression bandage with a normal crepe bandage.

Primary and secondary end-points will be measured at baseline and at 4, 8 and 12 weeks, except quality of life (only baseline and at 12 weeks).

Group Type ACTIVE_COMPARATOR

AQUACEL silver

Intervention Type OTHER

Silver Dressing

Interventions

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CUTIMED

Hydrophobic Dressing

Intervention Type COMBINATION_PRODUCT

AQUACEL silver

Silver Dressing

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Adult patients with chronic venous vascular ulcer located in lower limbs with signs of critical colonization, according to the criteria of Lazareth and Moore, which imply the presence of at least 3 of the following five:

1. Severe pain during dressing change
2. Perilesional edema.
3. Local edema.
4. Unpleasant smell.
5. Abundant pus
6. Microbial colonization higher than 100000 CFUs

Exclusion Criteria

* Patients younger than 18 years old.
* Venous ulcer with signs of infection which requires antibiotic therapy
* Venous ulcers that do not meet Lazareth and Moore criteria
* Arterial ulcers.
* Patients with type I or type II diabetes.
* Patients with immunosuppression of any etiology or in immunosuppressive treatment or with NSAIDs.
* Patients with rheumatoid arthritis in the acute phase.
* Patients with dermatitis prior to the appearance of the ulcer.
* Patients with neuropathy or lack of sensitivity of any etiology.
* Patients who, for local or systemic clinical reasons, will need to initiate antibiotic therapy.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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BSN Medical GmbH

INDUSTRY

Sponsor Role collaborator

Andalusian Health Service

OTHER_GOV

Sponsor Role collaborator

University of Malaga

OTHER

Sponsor Role lead

Responsible Party

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JOSE MIGUEL MORALES ASENCIO

Head of the Department of Nursing. Professor of Research and Evidence Based Health Care

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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José Miguel Morales Asencio, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Malaga

Locations

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University of Málaga

Málaga, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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José Miguel Morales Asencio, PhD

Role: CONTACT

0034951952833

Juan Carlos Morilla Herrera, PhD

Role: CONTACT

Facility Contacts

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José Miguel Morales Asencio, PhD

Role: primary

0034951952833

References

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Gonzalez de la Torre H, Quintana-Lorenzo ML, Perdomo-Perez E, Verdu J. Correlation between health-related quality of life and venous leg ulcer's severity and characteristics: a cross-sectional study. Int Wound J. 2017 Apr;14(2):360-368. doi: 10.1111/iwj.12610. Epub 2016 Apr 25.

Reference Type BACKGROUND
PMID: 27112627 (View on PubMed)

Hansson L, Hedner T, Dahlof B. Prospective randomized open blinded end-point (PROBE) study. A novel design for intervention trials. Prospective Randomized Open Blinded End-Point. Blood Press. 1992 Aug;1(2):113-9. doi: 10.3109/08037059209077502.

Reference Type BACKGROUND
PMID: 1366259 (View on PubMed)

Lazareth I, Ourabah Z, Senet P, Cartier H, Sauvadet A, Bohbot S. Evaluation of a new silver foam dressing in patients with critically colonised venous leg ulcers. J Wound Care. 2007 Mar;16(3):129-32. doi: 10.12968/jowc.2007.16.3.27015.

Reference Type BACKGROUND
PMID: 17385590 (View on PubMed)

Moore K, Hall V, Paull A, Morris T, Brown S, McCulloch D, Richardson MC, Harding KG. Surface bacteriology of venous leg ulcers and healing outcome. J Clin Pathol. 2010 Sep;63(9):830-4. doi: 10.1136/jcp.2010.077032. Epub 2010 Jul 29.

Reference Type BACKGROUND
PMID: 20671048 (View on PubMed)

Moore MF. Prospective, Descriptive Study of Critically Colonized Venous Leg Ulcers Managed With Silver Containing Absorbent Dressings and Compression. J Am Coll Clin Wound Spec. 2014 Sep 16;5(2):36-9. doi: 10.1016/j.jccw.2014.08.002. eCollection 2013 Aug.

Reference Type BACKGROUND
PMID: 26199888 (View on PubMed)

Pugliese DJ. Infection in Venous Leg Ulcers: Considerations for Optimal Management in the Elderly. Drugs Aging. 2016 Feb;33(2):87-96. doi: 10.1007/s40266-016-0343-8.

Reference Type BACKGROUND
PMID: 26833351 (View on PubMed)

Totty JP, Bua N, Smith GE, Harwood AE, Carradice D, Wallace T, Chetter IC. Dialkylcarbamoyl chloride (DACC)-coated dressings in the management and prevention of wound infection: a systematic review. J Wound Care. 2017 Mar 2;26(3):107-114. doi: 10.12968/jowc.2017.26.3.107.

Reference Type BACKGROUND
PMID: 28277989 (View on PubMed)

Wendelken ME, Berg WT, Lichtenstein P, Markowitz L, Comfort C, Alvarez OM. Wounds measured from digital photographs using photodigital planimetry software: validation and rater reliability. Wounds. 2011 Sep;23(9):267-75.

Reference Type BACKGROUND
PMID: 25879267 (View on PubMed)

González-Consuegra, R.V., Verdú, J., 2010. Proceso de adaptación al castellano del Charing Cross Venous Ulcer Questionnaire (CCVUQ) para medir la calidad de vida relacionada con la salud en pacientes con úlceras venosas. Gerokomos 21, 80-87

Reference Type BACKGROUND

Other Identifiers

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CUCO-UV

Identifier Type: -

Identifier Source: org_study_id

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